A comparison between enucleation of the prostate using holmium and thulium laser in volume over 80 cc: retrospective clinical study with 12-months follow-up


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Abstract

Aim: The aim of our study was to evaluate efficiency of thulium laser enucleation of the prostate (ThuLEP) for the treatment of benign prostatic hyperplasia (BPH). Materials and methods: A retrospective analysis of 112 patients with BPH who underwent ThuLEP (n = 60) or holmium laser enucleation of the prostate (HoLEP) (n = 52) at our institution from January 2017 to June 2017 was carried out. The perioperative data and complication rate were assessed. Severity of lower urinary tract symptom (LUTS) was evaluated after 1, 6 and 12 months using International Prostate Symptom Score [I-PSS], quality-of-life [QoL] score and maximum flow rate [Qmax]. To shorten learning curve, we modified the technique and simplified the intervention. To reduce noise during surgery, we performed ThuLEP using Vela XL. Results: There were significant differences in pre- and perioperative parameters, including operative time (113.15 ± 12.14 vs. 118.08 ± 15.76 min, p=0.46), decrease in serum sodium concentration (3.49 ± 0.83 vs. 3.48 ± 0.84 mmol/L, P = 0.97), hemoglobin drop (1.37 ± 0.18 vs. 1.43 ± 0.38 g/dL,p = 0.65), catheterization time (2.15 ± 0.38 vs. 2.27 ± 0.39 days, p=0.52) and hospital stay (6.95 ± 0.82 vs 7.56 ± 1.36 days, p=0.25) between the two groups (ThuLEP and HoLEP). Compared with the HoLEP group, intraoperative noise was lower in ThuLEP group (47.22 ± 10.31 vs. 59.45 ± 9.65 db,p < 0.05). At 1-, 6- and 12 months follow-up, the LUTS severity (I-PSS, QoL score and Qmax) were significantly improved in both groups in comparison with the baseline values. Furthermore, there was no difference in LUTS severity between two groups (p > 0.05). Conclusion: ThuLEP is comparable to the holmium laser in terms of efficiency, safety and indications and represent minimally invasive treatment option for patients with LUTS secondary to BPH.

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About the authors

S. V Popov

Saint Petersburg St. Luke’s Clinical Hospital; S. M. Kirov Military Medical Academy

MD, Chief and Head of the Center of Endourology and New Technologies; D, professor at the Department of Urology

I. N Orlov

GBUZ “Public Hospital of Saint Luca”

Ph.D., Head of the Department of Urology

A. G Martov

A.I. Burnazyan SRC FMBC, FMBA of Russia; GBUZ “City clinical hospital named after D.D. Pletnev of the Health Department c. Moscow”

Email: martovalex@mail.ru
MD, professor, Head of the urologic department №2; Head of the Department of Urology and Andrology

S. M Malevich

GBUZ “Public Hospital of Saint Luca”

Email: malevichsm@gmail.com
urologist, Department of Urology

I. V Sushina

GBUZ “Public Hospital of Saint Luca”

Email: irasushina@yandex.ru
urologist, Department of Urology

E. A Grin

GBUZ “Public Hospital of Saint Luca”

Email: sv.lukaendouro@gmail.com
urologist, Department of Urology

V. M Obidnyak

GBUZ “Public Hospital of Saint Luca”

Email: v.oobidnyak@gmail.com
urologist, Department of Urology

D. V Dovganskiy

GBUZ “Public Hospital of Saint Luca”

urologist, Department of Urology

T. M Topuzov

GBUZ “Public Hospital of Saint Luca”

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